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Short and long term motor delays associated with NAS can vary depending on the drug
or drugs the fetus is exposed to in-utero with the majority of motor delays occurring from the use
of opiates and methadone. The length of time and degree of fetal exposure to such drugs in-utero
can be the determining factors in whether or not motor abilities are affected. According to Logan
(2013), “Methadone-exposed infants have been found to exhibit increased motor rigidity,
dysregulated motor patterns and decreased activity by observation and maternal report on the
Bayley Infant Behavior Record”. The Bayley Infant Behavior Record (BSID-III) is used to
assess developmental functioning in infants and young children between the age of 1 month and
42 months of age with applications in cognition, language and motor development making this
found the following: At 9 months of age, 37.5 % of our sample of methadone exposed
infants showed clinically significant motor delays using the BSID-III compared to low
but typical development in the comparison group. Motor deficits were most prominent in
The motor deficits found in the first study of methadone exposed infants are focused on gross
motor skills which are movements associated with large muscle groups and whole body
In the second study of opiate exposed infants the finding are pointed more toward
psychomotor delays. Psychomotor refers to the relationship between cognitive functions and
physical movement. Psychomotor skills are physical skills such as movement, coordination,
manipulation, dexterity, strength, and speed all of which demonstrate the fine motor skills. 133
infants from opiate dependent moms and 103 healthy infants were tested with psychomotor
deficits being evident among the opiate exposed infants compared to the control group of healthy
development at 18 months, there was a significantly lower score on the McCarthy Motor Scale at
3 years of age for opiate-exposed children”. Hunt also states that, “Many investigators have been
less than willing than us to attribute significance to their finding because the opiate-exposed
infants had psychometric scores that fell within range. We challenge this premise and argue that
despite the small numbers studied, there are still clear differences in development between
opiate-exposed infants and controls. To clarify, findings for this study were based on the
Psychomotor Development Index pertaining to the Bayley Scales which tested both groups on
their level of psychomotor development by age and although the opiate-exposed infants were
technically within range, their scores were significantly lower than those of the control group
leading the researchers to believe that opiate exposed infants in fact have these delays due to
As mentioned above, many past researchers have failed to find the link between motor
delays and NAS because not meeting the age appropriate developmental milestones in motor
coordination can also be contributed to other factors such as; environment, parental involvement,
and genetic influences. Another big factor is that children all have their own unique pattern of
meeting milestones within a certain time frame. All of this considered, it has made it hard for
researchers to pinpoint motor delays strictly to NAS because most NAS infants fall into the
normal range. This range however, has been significantly lower than that of the control groups.
According to Logan (2013), “Few studies have used both biological and clinical measures to
evaluate developmental delays”. This can very well be part of the reason why the majority of
other studies done on developmental delays of NAS have limited information on motor deficits.
Not to mention, that most of the studies performed have had a hard time keeping participation
levels high (as was the case for Hunt), leaving them with a consistently low number of
participants over 42 months of age to assess for motor delays, which in turn has lead to very
mixed findings. With all that being said, there is an extreme need for further research to
investigate short and long term motor delays seen with NAS as well as a need for more long term
participation.
References:
Early Childhood Physical Development: Gross and Fine Motor Development. (n.d). Retrieved
early-3-7/article/12755 early-childhood-physical-development-gross-and-fine-motor-
development
Hunt, R. W., Tzioumi, D., Collins, E., &Jeffery, H.E. (2008). Adverse neurodevelopmental
outcome of infants exposed to opiate in-utero. Early Human Development, 84(1), 29-35.
doi:10.1016/j.earlhumdev.2007.01.013
Logan, B. A., Brown, M. S., & Hayes, M. J. (2013). Neonatal Abstinence Syndrome. Clinical
Obstetrics and Gynecology, 56(1), 186-192. doi:10.1097/grf.0b013e31827feea4